| Background and objective: The Pico Way Picosecond(Ps)laser is a novel picosecond Q-switched laser technology with multiple,extremely short pulse durations that works primarily by selective photoacoustic action to break down and remove melanin faster in the epidermis and dermis,and has recently been recognized as an emerging option for the treatment of melasma.The Medlite C6 laser,also known as Q-switched neodymiumdoped yttrium aluminum garnet laser(QSNY),is a non-ablative,large spot,low energy,nanosecond Q-switched laser device that works by selective photo-thermolysis to penetrate the skin’s surface layer and reach the epidermal basal and dermal layers It is now considered to be the new gold standard for the treatment of melasma in the Asian population.Although Q-switched lasers are widely used for the treatment of melasma,comparative studies of the efficacy and safety of the picosecond laser and Medlite C6 laser for the treatment of melasma have hardly been reported in China.Therefore,the aim of this study was to verify the efficacy and safety of picosecond and nanosecond Qswitched lasers for the treatment of melasma in the Chinese population,and to compare the efficacy and safety of the two lasers after treatment.Methods: The study recruited and enrolled 40 female subjects with Fitzpatrick III-IV skin type melasma who met the inclusion criteria and were randomly divided into two groups,A and B.The subjects in each group received three laser treatments at 4-week intervals,with a follow-up period of 4 and 12 weeks.Standardized photographs were taken before treatment,after 3 treatments and at 12 weeks follow-up for subjects in both groups using the OBSERV skin detector for archival purposes.A modified version of the Melasma Area and Severity Index(m MASI)was used to assess the efficacy of the two laser treatments before and after treatment.Adverse reactions were recorded in groups A and B for safety assessment and the subjects were asked to rate themselves according to a self-satisfaction scale.Finally,changes in skin lesions were observed before and after treatment in groups A and B by dermoscope techniques.The data were analyzed using the SPSS 25.0 statistical system.Results: All 40 subjects included in the study completed three treatments and follow-ups.The mean m MASI scores of the subjects in Group A were 6.14 ± 2.32 and 3.02 ± 1.01 before and after treatment with the picosecond laser,respectively,while the mean m MASI scores of the subjects in Group B were 5.43 ± 2.31 and 2.77 ± 1.18 before and after treatment with the Medlite C6 laser.The difference between the two groups before and after treatment was statistically significant(P < 0.05),but the difference between the two groups was not statistically significant(P > 0.05).After three treatments,the mean difference in m MASI scores between groups A and B before and after treatment was 3.13± 1.70 and 2.67 ± 1.39,respectively,and the statistical results showed that the difference between the two groups was not statistically significant(p > 0.05).During the follow-up period after the three treatments,the mean decline rate in m MASI scores was slightly higher in Group A subjects than in Group B subjects,49.30% ± 9.79% and 47.61% ±10.79%,in that order.Subjects in Group A had higher mean satisfaction scores than those in Group B,but the difference between the two groups was not statistically significant when compared(p > 0.05).Side effects such as mild erythema,desquamation and swelling were observed in a small number of subjects in both groups after treatment,but no serious adverse effects such as hyperpigmentation and hypopigmentation were observed in either group.After treatment,changes such as reduced discoloration and improved capillary dilation were observed under dermoscope in both groups.Conclusions: Both picosecond and nanosecond Q-switched lasers are safe and effective options for the treatment of melasma and are worthy of wider application.The study also compared the differences between the two lasers and found that the ultra-picosecond and Medlite C6 lasers have similar efficacy and safety in the treatment of melasma.However,it is worth noting that the picosecond laser offers a better experience during the treatment and a reduction in fine lines around the eyes and more refined skin can be observed at the end of the treatment. |
PDF Full Text Request